African Americans are more likely to develop Alzheimer’s than whites in the U.S., and less likely to be correctly diagnosed while their families often struggle to secure treatment from a medical system replete with bias against them.
However, a study led by Johns Hopkins and sponsored by the National Institutes on Aging is currently taking place at Hackensack Meridian Health, in Hackensack, NJ, with the goal to find better treatments that will help mitigate agitation in dementia patients.
The Escitalopram for Agitation in Alzheimer’s Disease clinical research study, according to Dr. Manisha Parulekar, co-director, the Center for Memory Loss and Brain Health, and a leading researcher for the study, is now underway to determine if a pill can safely and effectively reduce the symptoms of agitation and aggression in people with Alzheimer’s disease.
The Center, located at Hackensack University Medical Center Neuroscience Institute, provides opportunities for Dr. Parulekar to help older adults age successfully with a focus on longevity, maximizing independence and quality of life.
She said by participating in the study, patients can gain access to a potential treatment before it is widely available, an FDA-approved anti-depressant medicine, and receive high quality medical care, free of charge, including psychosocial counseling for patients and their caregivers to assist them in dealing with the practical problems and the deep emotional toll of Alzheimer’s disease.
“Agitation is very common and more than 80% of all Alzheimer’s patients will have it at one time or another,” Dr. Parulekar said. “Dementia may be expressed as paranoia, wanting to go home, becoming restless and unable to sit still, or with verbal or physical aggression and pushing. Simply stated, it’s the lack of one being able to control their behavior and it has a significant impact on both patients and caregivers.”
Alzheimer’s Disease and the Race Factor
About 14% of Blacks in America over the age of 65 have Alzheimer’s, compared with 10% of white people, according to the Centers for Disease Control and Prevention. But because many Blacks are not correctly diagnosed, the disparity is more than likely even greater.
Further, by 2060, the number of cases among African Americans is expected to increase fourfold.
Race accounts for some risk factors but genetics alone cannot fully explain the large disparities. “While I would agree that Alzheimer’s is an equal opportunity disease, it tends to affect females more than males,” Dr. Parulekar said. “It remains more common among older adults so your chances of memory loss and forms of dementia increase as you age. If you’re fortunate enough to live to 85 or above, you have a 40% chance of getting Alzheimer’s.
“One of the reasons we encourage African Americans to participate in our study is because early diagnosis is so important, if for no other reason than because people still have the capacity to make decisions for themselves. Another reason: the pathology of Alzheimer’s is believed to begin 10 to 15 years before the diagnosis, so it’s essential that we take care of ourselves even in our younger years – things like monitoring one’s blood pressure, exercising regularly and dieting if needed. We should make these thing part of our daily regiment, even when we’re in our 40s or 50s so that we have a fighting chance of avoiding the disease.
“There’s a host of negative lifestyles that make one more likely to develop Alzheimer’s including the routine use of medication like Benadryl to sleep which leads to a 15 to 20% better chance for one to succumb to the disease. Those who binge watch television more than 3 or 4 hours a day also have a far greater chance of developing Alzheimer’s.
The problems which Blacks face and which often lead to developing Alzheimer’s begin much earlier in life than one might suspect. Health conditions like heart disease and diabetes, both highly common among Black populations, are known risk factors. Other risk factors include where people live in relation to polluting industries, lack of food choices and poverty. Depression, high blood pressure, obesity and chronic stress may also increase the likelihood of developing Alzheimer’s.
“African Americans simply do not receive the same quality of health care throughout their lives as white people which also means they don’t get high quality treatment – or any treatment in some cases – for the conditions known to serve as high risk factors. This study and other clinical trials are so important because even when African Americans are diagnosed with Alzheimer’s, they remain less likely to receive medication that would ease the symptoms of Alzheimer’s and dementia-related disorders,” Dr. Parulekar said.
Dr. Carl V. Hill, chief diversity, equity and inclusion officer of the Alzheimer’s Association, emphasized the devastating impact that racism has on one’s life and health.
“Racism is trauma that can lead to increased stress, which can in turn cause health problems like inflammation which is a risk factor for cognitive decline,” Dr. Hill told a reporter with the Associated Press. “But because of this structural racism that creates poor access to health, medication and housing, those who experience racism and discrimination are not provided a pathway to lower their risk.”
Things You Can Do to Improve Your Lifestyle
Dr. Parulekar agreed with Dr. Hill about the negative impact on Black lives that occurs because of racism but she remains hopeful.
“The onus is on health care systems to help increase knowledge and access through multiple means to give African Americans greater confidence in and comfort with the nation’s health care systems,” she said.
“African Americans have a long history of being treated adversely within America’s health care systems so that’s a huge hurdle and fear to overcome. But as people are now living longer, it’s even more essential that one be diagnosed earlier in life.
“Studies show lifestyle modifications are effective: getting 7 to 8 hours of sleep each day; proactively managing depression or other forms of anxiety; engaging in physical activity like walking, jogging, or bicycling; and seeking and participating in some form of mental stimulation like engaging with family and friends or donating one’s time to others in need.
“But no matter what lifestyle modification one may choose, it’s important that they be things that a person truly enjoys. It could even be something like learning a new language or song or trying out new recipes,” Dr. Parulekar said.
For more information, visit ADtrial.org and share this information with others in support of Alzheimer’s Awareness Month.